Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo

Detalhes bibliográficos
Autor(a) principal: Salmazo, Pericles Sidnei [UNESP]
Data de Publicação: 2014
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://hdl.handle.net/11449/123909
http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/12-06-2015/000829953.pdf
Resumo: Background: AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated to increased number of cardiovascular events in this population and this association is not fully understood. Objectives: To identify the frequency of subclinical atherosclerosis in HIV-infected patients, compared with control subjects; to analyze the association of atherosclerosis with viral load, CD4 counts and antiretroviral treatment, cardiovascular risk factors and with the Framingham risk score, in HIV-positive patients. Methods: a prospective, cross-sectional, case-control study assessed the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 control subjects. Clinical evaluation included carotid intima-media thickness (IMT) measurement, the presence of plaque in the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), blood levels of hs-CRP, lipids, glucose, albumin, blood count, urea, creatinine and cardiovascular risk according to Framingham risk score criteria. Results: Patients were six years older than controls (43.2±10.5 vs. 37.9±11.5 years; p<0.001). Also presented lower prevalence of overweight / obesity (51.1 vs 63.1%; p=0.005) and higher frequency of active smoking (43.6 vs. 16.1%; p<0.001). Plaques were found in 37% of patients in the HIV group and 4% in the control group (p<0.001). Patients with carotid plaque were on average 11 years older than those without plaques (51.4±9.21 vs. 40.2±9.40 years; P<0.001) and had higher fasting glucose [90 (78, 100) vs. 83 (76.5, 90) mg/dl; p=0.012], total cholesterol [200 (178, 244) vs. 181 (156, 208.5) mg/dL; p<0.001], LDL-c [120.1 (96.2, 148.4) vs. 96.8 (80, 125) mg/dL; p<0.001] and triglycerides [188.5 (125.5, 288.5) vs. 150.5 (108, 226) mg/dL; p=0.010], mean systolic blood pressure 10 mmHg higher (132±21 vs. 121±16 mmHg; p<0.001) and mean diastolic blood pressure 6 mmHg ...
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spelling Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivoAteroscleroseAIDS (Doença) - PacientesFatores de riscoEstudos transversaisAIDS (Disease) - PatientsBackground: AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated to increased number of cardiovascular events in this population and this association is not fully understood. Objectives: To identify the frequency of subclinical atherosclerosis in HIV-infected patients, compared with control subjects; to analyze the association of atherosclerosis with viral load, CD4 counts and antiretroviral treatment, cardiovascular risk factors and with the Framingham risk score, in HIV-positive patients. Methods: a prospective, cross-sectional, case-control study assessed the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 control subjects. Clinical evaluation included carotid intima-media thickness (IMT) measurement, the presence of plaque in the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), blood levels of hs-CRP, lipids, glucose, albumin, blood count, urea, creatinine and cardiovascular risk according to Framingham risk score criteria. Results: Patients were six years older than controls (43.2±10.5 vs. 37.9±11.5 years; p<0.001). Also presented lower prevalence of overweight / obesity (51.1 vs 63.1%; p=0.005) and higher frequency of active smoking (43.6 vs. 16.1%; p<0.001). Plaques were found in 37% of patients in the HIV group and 4% in the control group (p<0.001). Patients with carotid plaque were on average 11 years older than those without plaques (51.4±9.21 vs. 40.2±9.40 years; P<0.001) and had higher fasting glucose [90 (78, 100) vs. 83 (76.5, 90) mg/dl; p=0.012], total cholesterol [200 (178, 244) vs. 181 (156, 208.5) mg/dL; p<0.001], LDL-c [120.1 (96.2, 148.4) vs. 96.8 (80, 125) mg/dL; p<0.001] and triglycerides [188.5 (125.5, 288.5) vs. 150.5 (108, 226) mg/dL; p=0.010], mean systolic blood pressure 10 mmHg higher (132±21 vs. 121±16 mmHg; p<0.001) and mean diastolic blood pressure 6 mmHg ...Fundamento: A AIDS representa importante problema de saúde pública da atualidade, assim como a doença aterosclerótica. Com a maior sobrevida entre os infectados pelo HIV, identificou-se aumento do número de eventos cardiovasculares nessa população. Os preditores e a fisiopatologia da associação HIV e aterosclerose não estão totalmente esclarecidos. Objetivos: Identificar a frequência da aterosclerose subclínica em pacientes HIV positivo, comparando-a com indivíduos controle; associar o diagnóstico de aterosclerose com carga viral, níveis de CD4 e tratamento antirretroviral; associar a presença de aterosclerose com fatores de risco cardiovasculares e escore de risco de Framingham, nos pacientes HIV positivo. Casuística e Métodos: estudo prospectivo, transversal, de casos e controles, que avaliou a presença de aterosclerose subclínica em 264 infectados pelo HIV e em 279 indivíduos do grupo controle. Foi avaliado o grau de espessamento médio-intimal de carótidas (EMIC), presença de placa em artérias carótidas, rigidez arterial através da velocidade de onda de pulso (VOP) e augmentation index (AIx), níveis séricos da PCR de alta sensibilidade, perfil lipídico, glicemia, albumina, hemograma, uréia, creatinina e o risco cardiovascular conforme critérios de Framingham. Resultados: Os pacientes foram, em média, seis anos mais velhos que os controles (43,2±10,5 vs. 37,9±11,5 anos; p<0,001), apresentaram menor frequência de sobrepeso / obesidade (51,1 vs. 63,1%; p=0,005) e maior frequência de tabagismo ativo (43,6 vs. 16,1%; p<0,001). Foram encontradas placas em 37% dos pacientes do grupo HIV e em 4% do grupo controle (p<0,001). Os pacientes com placas eram, em média, 11 anos mais velhos do que aqueles sem placas (51,4±9,21 vs. 40,2±9,40 anos; p<0,001) e apresentaram valores maiores de glicemia de jejum [90 (78; 100) vs. 83 (76,5; 90) mg/dL; p=0,012], colesterol total [200 (178; 244) vs. 181 (156; 208,5) mg/dL; ...Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)CNPq: PIBIC/16522FAPESP: 2010/11860-2Universidade Estadual Paulista (Unesp)Matsubara, Beatriz Bojikian [UNESP]Hueb, João Carlos [UNESP]Universidade Estadual Paulista (Unesp)Salmazo, Pericles Sidnei [UNESP]2015-06-17T19:34:17Z2015-06-17T19:34:17Z2014-02-10info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis65 f.application/pdfSALMAZO, Pericles Sidnei. Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo. 2014. 65 f. Tese (doutorado) - Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2014.http://hdl.handle.net/11449/123909000829953http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/12-06-2015/000829953.pdf33004064020P06990977122340795Alephreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPporinfo:eu-repo/semantics/openAccess2024-09-03T17:27:11Zoai:repositorio.unesp.br:11449/123909Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestrepositoriounesp@unesp.bropendoar:29462024-09-03T17:27:11Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
title Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
spellingShingle Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
Salmazo, Pericles Sidnei [UNESP]
Aterosclerose
AIDS (Doença) - Pacientes
Fatores de risco
Estudos transversais
AIDS (Disease) - Patients
title_short Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
title_full Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
title_fullStr Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
title_full_unstemmed Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
title_sort Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo
author Salmazo, Pericles Sidnei [UNESP]
author_facet Salmazo, Pericles Sidnei [UNESP]
author_role author
dc.contributor.none.fl_str_mv Matsubara, Beatriz Bojikian [UNESP]
Hueb, João Carlos [UNESP]
Universidade Estadual Paulista (Unesp)
dc.contributor.author.fl_str_mv Salmazo, Pericles Sidnei [UNESP]
dc.subject.por.fl_str_mv Aterosclerose
AIDS (Doença) - Pacientes
Fatores de risco
Estudos transversais
AIDS (Disease) - Patients
topic Aterosclerose
AIDS (Doença) - Pacientes
Fatores de risco
Estudos transversais
AIDS (Disease) - Patients
description Background: AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated to increased number of cardiovascular events in this population and this association is not fully understood. Objectives: To identify the frequency of subclinical atherosclerosis in HIV-infected patients, compared with control subjects; to analyze the association of atherosclerosis with viral load, CD4 counts and antiretroviral treatment, cardiovascular risk factors and with the Framingham risk score, in HIV-positive patients. Methods: a prospective, cross-sectional, case-control study assessed the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 control subjects. Clinical evaluation included carotid intima-media thickness (IMT) measurement, the presence of plaque in the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), blood levels of hs-CRP, lipids, glucose, albumin, blood count, urea, creatinine and cardiovascular risk according to Framingham risk score criteria. Results: Patients were six years older than controls (43.2±10.5 vs. 37.9±11.5 years; p<0.001). Also presented lower prevalence of overweight / obesity (51.1 vs 63.1%; p=0.005) and higher frequency of active smoking (43.6 vs. 16.1%; p<0.001). Plaques were found in 37% of patients in the HIV group and 4% in the control group (p<0.001). Patients with carotid plaque were on average 11 years older than those without plaques (51.4±9.21 vs. 40.2±9.40 years; P<0.001) and had higher fasting glucose [90 (78, 100) vs. 83 (76.5, 90) mg/dl; p=0.012], total cholesterol [200 (178, 244) vs. 181 (156, 208.5) mg/dL; p<0.001], LDL-c [120.1 (96.2, 148.4) vs. 96.8 (80, 125) mg/dL; p<0.001] and triglycerides [188.5 (125.5, 288.5) vs. 150.5 (108, 226) mg/dL; p=0.010], mean systolic blood pressure 10 mmHg higher (132±21 vs. 121±16 mmHg; p<0.001) and mean diastolic blood pressure 6 mmHg ...
publishDate 2014
dc.date.none.fl_str_mv 2014-02-10
2015-06-17T19:34:17Z
2015-06-17T19:34:17Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/doctoralThesis
format doctoralThesis
status_str publishedVersion
dc.identifier.uri.fl_str_mv SALMAZO, Pericles Sidnei. Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo. 2014. 65 f. Tese (doutorado) - Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2014.
http://hdl.handle.net/11449/123909
000829953
http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/12-06-2015/000829953.pdf
33004064020P0
6990977122340795
identifier_str_mv SALMAZO, Pericles Sidnei. Rastreamento e detecção precoce de doença aterosclerótica em pacientes com HIV positivo. 2014. 65 f. Tese (doutorado) - Universidade Estadual Paulista Júlio de Mesquita Filho, Faculdade de Medicina de Botucatu, 2014.
000829953
33004064020P0
6990977122340795
url http://hdl.handle.net/11449/123909
http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/12-06-2015/000829953.pdf
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dc.format.none.fl_str_mv 65 f.
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dc.publisher.none.fl_str_mv Universidade Estadual Paulista (Unesp)
publisher.none.fl_str_mv Universidade Estadual Paulista (Unesp)
dc.source.none.fl_str_mv Aleph
reponame:Repositório Institucional da UNESP
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